Wounds on protruding parts of the body are due to the anatomical complexity of the area very difficult to secure a dressing or bandage to. Efforts have been made to achieve better conformity, often by providing such dressings with irregular outlines.
To ensure good quality of life for a patient with a heel wound it is important that the dressing is pleasant to wear and also can be used when the patient is active, e.g. walking, and together with shoes. This requires a dressing being flexible, pliable and safely secured to the foot. Too bulky dressings or dressings with folds, flaps or sharp edges may give rise to discomfort or pressure points leading to pressure sores which are highly undesired. Furthermore, it is desirable if the dressing is capable of fitting a variety of shapes and sizes of the body parts and wounds without the necessarity of adaptation of the dressing e.g. by cutting.
Every time a wound dressing is changed, both the wound and the skin surrounding the wound is exposed to severe stress. It is therefore desired that the dressing is allowed to stay on the patient for as long as possible. This requires a dressing with good absorbency and an excellent fit to the anatomy of the body part.
The dressings may often comprise hydrocolloid as absorbent material, which has a limited absorption. When used on medium or highly exuding wounds, this leads to a more frequent change of dressing as well as the risk of maceration, leakage, detachment and contamination of the wound is increased.
In U.S. Pat. No. 5,827,213 (Jensen) is disclosed a planar dressing comprising an absorbent adhesive, such as hydrocolloid. The dressing comprises a central portion and a border portion surrounding the central portion. The border portion is having a thickness substantially less than the central portion. The dressing comprises at least one triangular gusset part extending from the border portion of the dressing and into the central portion. The gusset comprises an inwardly-extending fold line by use of which the dressing may be folded to a three-dimensional structure before application to the heel. It is only possible to apply the dressing in one way, and the folded gussets may give rise to uncomfort by sticking to the clothes or to pressure sores.
Heel ulcers are usually located on the plantar or on the side or dorsum of the foot. A wound dressing being flexible enough to cover different parts or all the mentioned parts of the foot may be preferred.
Various dressings for protruding body parts are known:
U.S. Pat. No. 2,440,235 (Solomon) discloses a T-shaped finger dressing. The stem of the T is covered by a substantially rectangular absorbent pad.
U.S. Pat. No. 2,253,108 (Casey) discloses a finger dressing with a central absorbent pad. The dressing is slitted in the length direction in order to achieve folding around the finger tip.
In CH Patent No. 321 693 (Conrads) is disclosed a wound dressing for the finger tip. The dressing comprises a first and a second part with an elongated absorbent pad extending from the first to the second part. An adhesive flange is extending from the absorbent pad of the second part. Incisions between the first and the second part renders it possible to avoid bulks when the dressing is folded around a finger tip.
However the structure of the three above mentioned dressings, when applied to the finger tip, is essentially two-dimensional and will not be suitable for application to a joint, such as the heel or the elbow.
European Patent No. 552 271 (Smith & Nephew) discloses a three-dimensional wound dressing of an absorbent material such as foam. The dressing is welded together to develop the form of an envelope to enclose the heel. It is not possible to adjust the size of the dressing to the heel resulting in discomfort. Thus it will only fit a limited range of sizes of body parts and a secondary dressing may further be needed to secure the dressing to the patient. The welded line may give rise to pressure sores as well as the absorption at this line may be limited.
U.S. Pat. No. 5,820,578 (Johansen) discloses a wound dressing comprising a central part and a plurality of adhesive flaps extending radially from the central part. The flaps are capable of moving and bending independently of each others. The dressing is most suitable for minor wounds, as it will be bulky if enlarged. Further, the adhesive may cold-flow and hereby connect the adhesive flaps in an undesired manner.
Thus, there is still a need for a conformable dressing with high absorbency, and an ability to fit different wound sites on protruding parts of a joint of the body, without wrinkling or appearing bulky. It has surprisingly been found that it is possible to achieve such a dressing by a dressing according to the present invention.